Individual
KANAK NAIDU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(318) 349-0256
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD.200714
LA
207P00000X
Emergency Medicine Physician
200714
LA
207P00000X
Emergency Medicine Physician
Primary
M-1725
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD.200714
STATE LICENSE
LA
Enumeration date
10/26/2006
Last updated
03/08/2019
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